Comminuted acetabular fractures have always been a difficult problem in the department of traumatic orthopaedics. The complex structures of vascular and nervous around the operative area create difficulty in the acetabular fracture reduction, as well as the inability of exposure and the limited area for the screw insertion. Complex acetabular fractures, which are comminuted fractures of the anterior column or posterior column or even both columns can occur at the same time due to sever trauma, are often combined with an acetabulum quadrilateral plate fracture. For the surgical treatment of this kind of fractures, it is prone to hip osteoarthritis, necrosis of the femoral head and so on because of poor fracture reduction.
At present, the surgical treatment of acetabular fractures involving the quadrilateral plate mainly includes the fixation of the anterior column using plates after reduction of the fracture by an anterior approach, and then using lag screws to fix the posterior column or adding another posterior approach.
At present, there are many problems in the surgical treatment of acetabular fracture such as difficulty of fracture reduction, difficulty of shaping and placing plate after reduction, instable fixation, high risk of damaging the blood vessels and nerves, long operative time, large amount of bleeding and many postoperative complications et. al. In addition, the current surgical method is difficult to fix the quadrilateral plate fracture especially when the fractures are severely comminuted and displaced. It may result in big surgical trauma, unsatisfactory fracture reduction and fixation, malunion of fracture, postoperative traumatic arthritis, femoral head necrosis and other bad outcome. For some osteoporotic patients, it is more likely that occurring loosening or displacement of the internal fixations. How can we effectively deal with this type of fracture is the focus of current research.
The patent CN201831946U discloses an anatomical plate of the acetabulum quadrilateral plate that includes a long strip of plate and a buttress plate fixing the fracture of the quadrilateral area. But there are some disadvantages: the mechanical mismatch with the displacing direction of fracture, the limited fixation of quadrilateral plate, and the problem that the anterior and posterior columns can't be fixed simultaneously. Consequently, better internal fixation devices need be invented as soon as possible.